The nurse has determined a client has absent bowel sounds because ...

[rosent76]

The nurse has determined a client has absent bowel sounds because no sounds have been heard in all four quadrants for :
 
  1. 1 minute.
  2. 2 minutes.
  3. 30 seconds.
  4. 5 minutes.

Question 2

The nurse is preparing to conduct an abdominal assessment on a client and realizes that this assessment should be performed in the order of:
 
  1. inspection, palpation, auscultation, and percussion.
  2. inspection, auscultation, percussion, and palpation.
  3. auscultation, palpation, percussion, and inspection.
  4. percussion, palpation, inspection, and auscultation.

[kjo;oj]

Answer to Question 1

4
The nurse must listen for 3 to 5 minutes before concluding the patient has absent bowel sounds. Auscultating for 30 seconds or 1 or 2 minutes is not adequate to determine the absence of bowel sounds.

Answer to Question 2

2
The order of abdominal assessment is inspection, auscultation, percussion, and palpation. Auscultation is performed second because palpation and percussion can alter bowel sounds. The other choices list the incorrect order for conducting this assessment.